Tales of a Foreign Service Family

an unwanted diagnosis

I’ve always found it difficult to know what information about my life I should scatter out into the sea of the Internet. For some people — the ones who share that they’re hungry for a sandwich, and then that they went to get a sandwich, and then that the sandwich was so amazing — this isn’t a concern. If something is going on, they just blog or update their Facebook status about it. There’s a nice simplicity to that, and while some whine about having to drudge through the minutiae of other people’s lives in their Facebook feeds, I actually find it quite interesting. But that’s when it comes to other people. Me, I’m a bit more private than that. I like to think of my Internet presence as a highlights reel rather than a play-by-play. I try not to stick everything in — just the good stuff.

But there’s my dilemma. Life isn’t just about the good stuff; bad creeps in occasionally too. And how am I to handle that bad stuff online? I faced that question last March when my dad passed away, and I’m facing it again now. Not knowing how much I want to reveal, I’ve opted so far to say nothing at all. But that hasn’t really been working. There’s a difference between not disclosing every little thing and intentionally holding back the most important thing. Holding back the most important thing feels not only dishonest but also uncomfortable. And so I guess (at least for me) that’s when a lowlight becomes scatter-worthy.

Here’s what has been going on.*

January 1: Andy found a lump that he promptly had examined by the Embassy doctor, who didn’t think it was anything serious.

January 3: The doctor arranged for blood tests and a sonogram to be done in Cotonou just in case.

January 4: The results were analyzed both by the Embassy doctor and the Regional Medical Officer; neither thought there was cause for worry. Still, Andy and I remained concerned. My dad’s fairly recent death of throat cancer was fresh in my mind, and Andy lost his mom when he was little to colon cancer too. To us, a lump meant cancer, and the possibility of cancer — however tiny — was too serious to ignore. Fortunately the Regional Medical Officer approved a medevac for Andy for further evaluation. Flynn and I were approved to fly back the the U.S. too.

January 10: We arrived in D.C.

January 11: Within the first five minutes of Andy’s appointment, a urologist at George Washington University diagnosed him with testicular cancer.

January 12: Andy underwent surgery to get rid of two cancerous tumors. They were sent for biopsy to determine specifically what kind of cells they contained.

January 18: Andy had a CT scan to see whether and where the cancer had spread.

January 20: Nine days after the diagnosis of cancer — awful days of waiting, worrying, and fearing the worst — the results from blood tests, biopsy, and CT scan were finally all in. And the news was good. In fact, given the circumstances, it was the best possible news we could have received: his cancer was both the less dangerous kind and was caught before it had spread anywhere else. The survival rate for this sort of thing (with proper follow-up care) is essentially 100%.

We are all so happy, especially this little one who actually just moved on from his incessant muttering of “Mama” to a brand new word: “Dada.” Coincidence? I think not.

Though we have the diagnosis and prognosis, there are still many unknowns.

What follow-on treatment will we decide is best? Andy might undergo a low dose of radiation or chemo to slash the odds of recurrence from 15% down to virtually none, or he might just have CT scans and blood tests regularly for the next few years to monitor the situation, and only go the radiation or chemo route if that becomes necessary. (Because his cancer was the less dangerous, slow growing kind, this is perfectly safe.) When we decide on the best follow-on treatment, how long will it take? And what will I do work-wise during that time? After treatment, will Andy be medically cleared to return to Cotonou, or will I have to find an assignment somewhere else? What will become of Andy’s spot on the Foreign Service Register? Appointments Monday and Tuesday with an oncologist and then a radiation oncologist will allow us to start tackling these unknowns.

For now, we’re focusing on the one thing we do know: when all is said and done, it looks like Andy will be okay.

* Posted with Andy’s okay, of course. He says hello and thanks for reading, but he’s still enjoying the “I have cancer” excuse to justify lazing around all day and basking in decent bandwidth and the wonders of Hulu; as a result he has no free time to actually compose a blog entry himself.

This must be so difficult Alexis, to live through and to write about. But I imagine the writing and the sharing have done you a lot of good. Wonderful that you’ve all now had some relief and the prognosis is good.

My thoughts and warm wishes are with you as you take it one day at a time…

Alexis- I so very rarely come to your blog, but am always eager to find what you have been up to and where your adventures have led. More often than not, I leave with new ways to think about all the things that are meaningful and important to me. Thank you for sharing this, for reminding me that the people in our lives are truly the most important and that sharing my life with them is not so much about losing my privacy as it is about gaining support. My thoughts and good wishes are with you and your family..

Wow, what a scare! Good for you for insisting on getting second/third opinions and coming to the US to get it checked out. You just never know with these things. Glad to hear that the prognosis is good. I hope everything else works out well. Did you find a baby carrier? We are not using our Baby Bjorn any more. Please let me know if you need anything else.

Thanks everyone for all the support. If there are any FS folks out there who have dealt with curtailments or managing medical issues from overseas, I’d love to hear from you. The intel we’re getting currently is that the default is for Andy not to be cleared to go back and for me to have to curtail, but if we really want to get back to Benin and are willing to send Andy back to the U.S. ourselves for check-ups, then we can fight for that and we might be able to make it happen. We’re torn. There are a lot of reasons it makes sense to try to get back to Benin, but we of course don’t want to compromise anything medically.

I am so sorry to hear this news, but really glad to see how being proactiv and following your gut was the best thing to do. I lost my mother to cancer just before we arrived in Uganda and couldn’t help but feel better knowing my fear of cancer being ignored or misdiagnosed was also shared. We met in ConGen and I follow your blog to see how our Africa experiences compare. Thank you for sharing. I wish for everything to work out in your favor as you make some tough choices.

@Erica – I’m so sorry to hear about your mom. If it makes you feel better about medical care at post, even though post wasn’t able to properly diagnose, they didn’t give us ANY hassle about continuing to follow-up in the U.S. We were prepared to pay for a medevac ourselves if it wasn’t officially recommended/approved, but everyone involved from post through the regional med unit was extremely supportive and perfectly willing to err on the side of being overly cautious.

Like everyone else, I’m sorry that you guys are going through such a hard time but also glad that it’s turned out as well as could be thus far. Good luck figuring out the next steps, and I’ll keep my fingers crossed to see you back at Livingstone!

I’m so sorry to learn of this — and so relieved that Andy is getting the medical attention he needs. What ups and downs you two have experienced in the past two years! But again, thank God, it’s working out. I’m so glad you persisted and chose to listen to your inner voice. Take good care and God be with you.

Wow. This is intense news. I’m so glad you caught it when you did. It sounds like this opens up many questions for you guys and I’m sure it’s so hard to be patient for all of the answers. Best wishes to you both on the job/post situation and for Andy’s continued recovery.

Alex, I’m so sorry to read you’ve been through such a nervewracking experience. So glad to hear the prognosis is so good. I’m currently in the U.S. going through a similar family medical emergency, and I haven’t been able to bring myself to blog about it yet, even though it is clearly the most important thing right now. Thanks for your blog and saying in words what I haven’t been able to articulate. Thinking of all of you right now as you navigate this new reality.

Oh my Alex. What a crazy start to your year. Good on you both for standing firm on getting medevaced … navigating the MED system … and moving forward after a scary diagnosis. Thinking of you and hoping all goes well while you figure out what to do during these next stages of recovery!

Oh, scary stuff. I’m sorry you’re having to go through this. We faced a medical curtailment back in 2004 when our baby got sick. Happy to share how it worked for us if you need any information. Bottom line: focus on your health and the rest will work out eventually. But it is stressful to worry about health AND job simultaneously. I don’t think back on those days fondly.

Hi Alex and Andy,
Congratulations on a speedy follow through to your diagnosis and treatment. I actually used to work at GW’s Urology Clinic, until we moved in Nov 2011 for the FS, and all the physicians/staff there should take excellent care of you. If you have any questions, please feel free to email me. You both have my support too over here in Romania.

That is one crazy start to 2012. Will keep your recovery in prayer. We haven’t had a med-evac to deal with in our 10 years with FS, but I agree with others: focus on your health and healing, let the rest pan out. You did that with getting additional opinions, and it was the right decision. Wishing you all the best as you work your way back to health and peace of mind. Love the timing of “Dada”!